Hydropneumothorax

Hydropneumothorax is defined as the presence of both air and fluid within the pleural space[1]. An upright chest x-ray will show air fluid levels. The horizontal fluid level is usually well defined and extends across the whole length of hemithorax.

Hydropneumothorax
A hydropneumothorax with white arrow point to the lung's pleura
SpecialtyEmergency medicine

Signs and symptoms

This can be remembered by 4 'S': straight line dullness, shifting dullness, splash, sound of coin.

Causes
  • Iatrogenic: Introduction of air during pleural fluid aspiration in effusion
  • Presence of a gas-forming organism
  • Thoracic trauma

Diagnosis

Diagnosis can be via CXR. CT is better to outline borders of air fluid levels, however, CT has a greater radiation exposure.

Treatment

Treatment is mostly the treatment includes ICD (intercostal drainage) of fluid and air and treatment of underlying conditions.

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References
  1. Clarke, Christopher; Dux, Anthony (2017). Chest X-rays for Medical Students. John Wiley & Sons. p. 82. ISBN 9781119426721. Retrieved 6 November 2017.
Classification
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